“It’s All Under Control” – Description of the Dissociation Between Psychological Symptoms and Autonomic Arousal in People With Obsessive-compulsive Symptoms: A Case-control Study

Background: Recent literature indicates a significant association between obsessive-compulsive symptoms, depression, anxiety, and suicidal ideation. It appears that psychological symptoms can influence sympathetic activity as well. Our hypothesis suggests that autonomic arousal, as measured by electrodermal activity (EDA), may be lower in people with obsessive-compulsive disorder (OCD) compared to healthy controls. Methods: To test the experimental hypothesis, eightytwo people diagnosed with OCD were consecutively recruited, and their psychological symptoms were compared to those of a control group along with autonomic arousal. Psychological symptoms were investigated through Symptom Checklist 90-Revised (SCL-90-R). Additionally, baseline, reactivity, and recovery EDA values were recorded during a Psychophysiological Stress Profile (PSP). Results: The results revealed that people with OCD exhibited significantly higher levels of obsessive-compulsive symptoms (U = 1953.00; p <0.001), depression (U = 2711.00; p < 0.001), anxiety (U = 2879.00; p <0.001) as well as suicidal ideation (15.85% in the OCD group and 3.22% in the controls; chi 2 = 6.03, p = 0.01) in comparison with the control group. The global severity index (U = 2317.50; p <0.001) was higher in OCD people as well. However, there were no differences in baseline, reactivity, and recovery EDA levels between the two groups. Correlational analysis indicated that obsessive-compulsive symptoms were negatively associated with reactivity EDA levels (Objective stressor: rho s = -0.29, p = 0.03; subjective stressor: rho s = -0.28, p = 0.03) in the control group. Conclusions: These findings highlight a dissociation between subjective and objective measures of mental distress of OCD people. The data suggest that obsessive-compulsive symptoms may play a repressive and suppressive role in managing negative emotions and in the avoidance of autonomic arousal during stress.